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You’re referring to the letter titled “Advocating for a 3‑Pronged Approach to Treating PANS” by Bernstein, Wilson, and Breithaupt, published in Pediatrics on July 29, 2025 (X-MOL).

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🟢 Is It Free to Access?

• The letter is published in a paywalled letter-to-the-editor in Pediatrics, and as of now it is not freely accessible. Full text requires:

  • Institutional or personal subscription, or

  • Pay-per-view access via the American Academy of Pediatrics website (Pediatrics, Pediatrics).

• There is no indication that this particular piece is open-access or freely available.

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📚 Key Content: The 3‑Pronged Treatment Strategy

According to the authors, aligned with the PANS/PANDAS Research Consortium guidelines (2017), effective management of Pediatric Acute‑Onset Neuropsychiatric Syndrome (PANS) should involve:

1. Concurrent psychiatric and behavioral interventions, such as:

   • Selective serotonin reuptake inhibitors (SSRIs)

   • Cognitive-Behavioral Therapy (CBT) and parent management training (Pediatrics)

2. Immunomodulatory treatments, including:

   • Anti-inflammatory medications like NSAIDs or corticosteroids

   • Invasive approaches (IVIG, plasma exchange, biologics) where indicated (Pediatrics, Aspire)

3. Targeted antimicrobial therapy, addressing known or suspected infectious triggers, including empirical antibiotics even when Group A Streptococcus (GAS) is not documented (Drohara)

The letter stresses that an effective treatment plan must address all three components concurrently and not focus on any single domain alone (Pediatrics).

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🧠 Broader Context: Consortium Guidelines

• The PANS/PANDAS Research Consortium published comprehensive treatment guidelines in 2017, emphasizing coordinated approaches across behavioral, immune, and infection-targeted treatments (PPN).

• Organizations like ASPIRE summarize these same principles, urging individualized treatment tailored to disease severity and symptom profile (Aspire).

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✅ Summary Table

Scope	Summary
Access	Not freely available—publication is behind paywall
Main recommendation	A 3‑pronged approach combining psychiatric, immune, and infection‑targeted therapies
Core treatment elements	SSRIs/CBT, NSAIDs/steroids/IVIG, antimicrobial therapies

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💡 Need Help Accessing or Going Further?

• Purchase option: You can buy the article directly via the Pediatrics journal site.

• Institutional access: If you’re affiliated with a university or hospital, they may provide access.

• Author contact: Reach out to Dr. Bernstein via the listed correspondence details to request a personal copy.

I can also help you explore:

• More detailed treatment protocols from the full Consortium guidelines,

• Patient-oriented summaries or toolkits (e.g., ASPIRE),

• Related studies on PANS/PANDAS treatment efficacy.

Just let me know!